senassonvatmovnee SSTANDARD QUOTATION COCUMENT FOR QUOTATIONS ABOVE R2 000.01, aan 4. PURPOSE OF THE FORIE ‘Any prion (nto jit) may mae an feo tein a i non od In ie wth th pines of ranspareey, aecurtiy, lrgarally. andes as nse the Constton ete Rep of South Anca ane Tater epressedn vos pecs ef ein, roauked {orth ar make ths drain yspod lh dels oquted hereunder ate a pct’ ar ne nth Regie for Tend Dsus s/o Us cf esti Supper, thl paren wil atomic bo diguoiod {om be bi proses, 21, sth bdo or ary ots rocors tutes tareholos wombat / panes ery pes hing acacing eet! inthe (oreo, oye byte le? eae 214. so, fursh paar he nares, nv denty numbers, naples, sit erpoycenunber a ce propel decker sans / shorcidera rember pata ny peson having cnt om LL ane TITY NUMBER INANE OF STATE WSTTUTION 22. _Doyou,orany prion crnaie wiht blr. havea raion wit any person who samployed byte ecuragistuion? YES J NO 22, Meo. fanih pair: 23. oes bidder or ny of ts det tse /shareoldrs marbers/parers oan person hang acalingilerestintwe yes) No leoprec nav ay Ios nay ete elo enor hater rho thy are dang ore ona? 234. ao, tunis ptt: 3 DECLARATION | he undeignes (nie) Incusnting the aecompering a heey mae Ihe fooing tater aca Tbe Ta ae Ta HY TST 1. hae rad ar | understand he conten ofthis clos: 32. |uncerstnd at te accompanyng bi wtb daquatod I is dsclsues ound nto be te ad cate in every rast 83. The le has are athe secompanting independent on, ad wot coroutalon, camera afar or ranger th ry _ampiter Honeer, communion tween patarsin ajo verde o consort wl ret be cond scale ng 34, ination, tee nave bean no corsuaons, communion, agreement arangement wih ny copattr egacing th ay, sry specials, pies, icusng mathe, fais o formulas usd lo cfc pices, art slozsba, he eon deter oa ato ‘Start e dng wih he latn Pat win the ba and conten Selvey pares te prose o soscns o wich hs bd in ‘hes 35, Tatas oft oocompanying td have not been nd wl tb, doss by Ihe der, det orindety foany compar, oro the dete and inwetthe tia apeing a he ring fhe onc. 38. ‘Tore neve ben no corstions conmunicalns, agroerons or arangemens made by th Bie wth nyo ote procrng inaitatonn ‘alten ois prsareman procees porto an dang the ding process wip 1 pode Caiteston on ie i subiog ete 20 eo y th iatlton nd Ie adr was sinning of i pela oe orton forthe Hs, 7. Tamwore tal, pain an who peso any cherry proiesfconbal ay reticive paces ele ode ard contacts bidet ‘ae auapous il be epetad othe Cmpetion Camssin for ivesigaion an posaie ripston of asrnstsive praosin wm sation 3, {the Competon Act Ne 690198 po ay ba repo to ha Naan Prosaciing Athy (NPA) fer cal veasatin and ern be ‘este om condiing buss win te pu sce paned nl scan en (10 years nr Ine Proven ana Comat of Comp Pais AN 120! 204 ray ota appeatie leper | CERTIEY THAT THE INFORMATION FURNISHED IN PARAGRAPHS 1,2 and 3 ABOVE IS CORRECT. {ACCEPT THAT THE STATE MAY REJEOT THE BID OR ACT AGAINST ME IN TERNS OF PARAGRAPH 6 OF PFMA SC INSTRUCTION 03 OF 2021122 ON PREVENTING AND COMBATING ABUSE INTHE SUPPLY CHAN MANAGEMENT SYSTEM SHOULD THIS DECLARATION PROVE TO BE FALSE. x TE OF BODER ‘SGNATORE POSTION ORE LAEEEINGena es moet nya ay, pe pom te a baw & Page 3 of 13